Provider Demographics
NPI:1922215649
Name:CANOS AND CANOS MD INC
Entity Type:Organization
Organization Name:CANOS AND CANOS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD FAMILY PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:PORTIA
Authorized Official - Middle Name:VERA CRUZ
Authorized Official - Last Name:CANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-532-0220
Mailing Address - Street 1:1920 SO 9TH ST
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638
Mailing Address - Country:US
Mailing Address - Phone:740-532-0220
Mailing Address - Fax:740-532-5088
Practice Address - Street 1:1920 SO 9TH ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638
Practice Address - Country:US
Practice Address - Phone:740-532-0220
Practice Address - Fax:740-532-5088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6842Medicare PIN